Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines
There is building evidence in India that the delivery of health services suffers from an actual shortfall in trained health professionals, but also from unsatisfactory results of existing service providers working in the public and private sectors....
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2014
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| Online Access: | http://documents.worldbank.org/curated/en/2014/06/19737148/parallel-systems-human-resource-management-indias-public-health-services-view-front-lines http://hdl.handle.net/10986/19065 |
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okr-10986-19065 |
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oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
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World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ABILITY TO PAY ACCOUNTABILITIES ACCOUNTABILITY ACCOUNTABILITY MECHANISMS AGED ANTI-CORRUPTION ASSETS AUDITOR AUDITORS BASIC SERVICES BULLETIN CAPACITY BUILDING CITIZEN CITIZENS CIVIL SERVANT CIVIL SERVANTS CIVIL SOCIETY COLLUSION COMMUNITY HEALTH CONFIDENCE CORRUPTION COUNSELING CRIMINAL CRIMINAL LAW DECISION MAKING DELIVERY OF HEALTH CARE DELIVERY OF HEALTH SERVICES DELIVERY SYSTEM DELIVERY SYSTEMS DEMOCRACY DEVELOPING COUNTRIES DEVELOPMENT POLICY DISEASES DOCTORS ECONOMIC PERSPECTIVES ECONOMIC POLICIES ECONOMIC REVIEW EVALUATION TECHNIQUES FAMILY WELFARE FEMALE LITERACY FINANCIAL RESOURCES FOCUS GROUP DISCUSSIONS GOOD GOVERNANCE GOVERNMENT AGENCIES GOVERNMENT OFFICIALS HEALTH AFFAIRS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CENTRES HEALTH COMMITTEES HEALTH DELIVERY HEALTH DELIVERY SYSTEM HEALTH FINANCING HEALTH INFRASTRUCTURE HEALTH INSURANCE HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH OFFICIALS HEALTH OUTCOMES HEALTH PLANS HEALTH PROFESSIONALS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HOSPITAL HOSPITALS HOUSEHOLD SURVEYS HR HUMAN RESOURCE MANAGEMENT HUMAN RESOURCES HUMAN RESOURCES MANAGEMENT IMMUNIZATION INCOME INCOME DISTRIBUTION INFORMAL SECTOR INPATIENT CARE INSURANCE SCHEMES INTERMEDIARIES INTERNAL MIGRATION KICKBACKS LEADERSHIP LOCAL COMMUNITY LOW-INCOME COUNTRIES MANAGEMENT SYSTEMS MARITAL STATUS MEDICAL SCHOOL MIGRATION MINISTER MINISTRIES OF HEALTH MINISTRY OF HEALTH MINORITY MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SYSTEMS NURSE NURSES NURSING NUTRITION OUTPATIENT CARE PATIENT PATIENT CHOICE PATIENTS PATRONAGE PEDIATRICS PENSIONS PHYSICIAN PHYSICIANS PLACE OF RESIDENCE POLICY DISCUSSIONS POLICY MAKERS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLITICAL CHANGE POLITICAL CORRUPTION POLITICAL LEADER POLITICAL LEADERS POLITICAL PARTIES POLITICAL SUPPORT POLITICIAN POLITICIANS POLLUTION POOR HEALTH POPULAR SUPPORT PRIMARY CARE PRIVATE CARE PRIVATE HEALTH SERVICES PRIVATE SECTOR PRIVATE SECTORS PROBABILITY PROGRESS PSYCHOLOGY PUBLIC ADMINISTRATION PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH SERVICES PUBLIC HEALTH SYSTEM PUBLIC HEALTH WORKERS PUBLIC HOSPITALS PUBLIC OFFICIALS PUBLIC OPINION PUBLIC PROVIDERS PUBLIC SECTOR PUBLIC SERVICE PUBLIC SERVICES PUBLIC SPENDING QUALITY CARE QUALITY OF CARE QUANTITATIVE RESEARCH REFORM EFFORT RESEARCH METHODS RURAL AREAS RURAL HEALTH CARE SANCTIONS SANITATION SENSITIVE ISSUES SENSITIVE TOPICS SERVICE PROVIDERS SERVICE PROVISION SOCIAL DEVELOPMENT SOCIAL INFRASTRUCTURE SPOUSE SPOUSES STATE GOVERNMENT STATE GOVERNMENTS SURGERY THEFT TRANSPARENCY URBAN AREAS URBAN CENTERS VICTIMS WORKERS |
| spellingShingle |
ABILITY TO PAY ACCOUNTABILITIES ACCOUNTABILITY ACCOUNTABILITY MECHANISMS AGED ANTI-CORRUPTION ASSETS AUDITOR AUDITORS BASIC SERVICES BULLETIN CAPACITY BUILDING CITIZEN CITIZENS CIVIL SERVANT CIVIL SERVANTS CIVIL SOCIETY COLLUSION COMMUNITY HEALTH CONFIDENCE CORRUPTION COUNSELING CRIMINAL CRIMINAL LAW DECISION MAKING DELIVERY OF HEALTH CARE DELIVERY OF HEALTH SERVICES DELIVERY SYSTEM DELIVERY SYSTEMS DEMOCRACY DEVELOPING COUNTRIES DEVELOPMENT POLICY DISEASES DOCTORS ECONOMIC PERSPECTIVES ECONOMIC POLICIES ECONOMIC REVIEW EVALUATION TECHNIQUES FAMILY WELFARE FEMALE LITERACY FINANCIAL RESOURCES FOCUS GROUP DISCUSSIONS GOOD GOVERNANCE GOVERNMENT AGENCIES GOVERNMENT OFFICIALS HEALTH AFFAIRS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CENTRES HEALTH COMMITTEES HEALTH DELIVERY HEALTH DELIVERY SYSTEM HEALTH FINANCING HEALTH INFRASTRUCTURE HEALTH INSURANCE HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH OFFICIALS HEALTH OUTCOMES HEALTH PLANS HEALTH PROFESSIONALS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HOSPITAL HOSPITALS HOUSEHOLD SURVEYS HR HUMAN RESOURCE MANAGEMENT HUMAN RESOURCES HUMAN RESOURCES MANAGEMENT IMMUNIZATION INCOME INCOME DISTRIBUTION INFORMAL SECTOR INPATIENT CARE INSURANCE SCHEMES INTERMEDIARIES INTERNAL MIGRATION KICKBACKS LEADERSHIP LOCAL COMMUNITY LOW-INCOME COUNTRIES MANAGEMENT SYSTEMS MARITAL STATUS MEDICAL SCHOOL MIGRATION MINISTER MINISTRIES OF HEALTH MINISTRY OF HEALTH MINORITY MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SYSTEMS NURSE NURSES NURSING NUTRITION OUTPATIENT CARE PATIENT PATIENT CHOICE PATIENTS PATRONAGE PEDIATRICS PENSIONS PHYSICIAN PHYSICIANS PLACE OF RESIDENCE POLICY DISCUSSIONS POLICY MAKERS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLITICAL CHANGE POLITICAL CORRUPTION POLITICAL LEADER POLITICAL LEADERS POLITICAL PARTIES POLITICAL SUPPORT POLITICIAN POLITICIANS POLLUTION POOR HEALTH POPULAR SUPPORT PRIMARY CARE PRIVATE CARE PRIVATE HEALTH SERVICES PRIVATE SECTOR PRIVATE SECTORS PROBABILITY PROGRESS PSYCHOLOGY PUBLIC ADMINISTRATION PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH SERVICES PUBLIC HEALTH SYSTEM PUBLIC HEALTH WORKERS PUBLIC HOSPITALS PUBLIC OFFICIALS PUBLIC OPINION PUBLIC PROVIDERS PUBLIC SECTOR PUBLIC SERVICE PUBLIC SERVICES PUBLIC SPENDING QUALITY CARE QUALITY OF CARE QUANTITATIVE RESEARCH REFORM EFFORT RESEARCH METHODS RURAL AREAS RURAL HEALTH CARE SANCTIONS SANITATION SENSITIVE ISSUES SENSITIVE TOPICS SERVICE PROVIDERS SERVICE PROVISION SOCIAL DEVELOPMENT SOCIAL INFRASTRUCTURE SPOUSE SPOUSES STATE GOVERNMENT STATE GOVERNMENTS SURGERY THEFT TRANSPARENCY URBAN AREAS URBAN CENTERS VICTIMS WORKERS La Forgia, Gerard Raha, Shomikho Shaik, Shabbeer Maheshwari, Sunil Kumar Ali, Rabia Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| geographic_facet |
South Asia India |
| relation |
Policy Research Working Paper;No. 6953 |
| description |
There is building evidence in India that
the delivery of health services suffers from an actual
shortfall in trained health professionals, but also from
unsatisfactory results of existing service providers working
in the public and private sectors. This study focusses on
the public sector and examines de facto institutional and
governance arrangements that may give rise to
well-documented provider behaviors such as absenteeism,
which can adversely affect service delivery processes and
outcomes. The paper considers four human resource management
subsystems: postings, transfers, promotions, and
disciplinary practices. The four subsystems are analyzed
from the perspective of front line workers, that is,
physicians working in rural health care facilities operated
by two state governments. Physicians were sampled in one
post-reform state that has instituted human resource
management reforms and one pre-reform state that has not.
The findings are based on quantitative and qualitative
measurement. The results show that formal rules are
undermined by a parallel modus operandi in which desirable
posts are often determined by political connections and side
payments. The evidence suggests an institutional environment
in which formal rules of accountability are trumped by a
parallel set of accountabilities. These systems appear so
entrenched that reforms have borne no significant effect. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
La Forgia, Gerard Raha, Shomikho Shaik, Shabbeer Maheshwari, Sunil Kumar Ali, Rabia |
| author_facet |
La Forgia, Gerard Raha, Shomikho Shaik, Shabbeer Maheshwari, Sunil Kumar Ali, Rabia |
| author_sort |
La Forgia, Gerard |
| title |
Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| title_short |
Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| title_full |
Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| title_fullStr |
Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| title_full_unstemmed |
Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines |
| title_sort |
parallel systems and human resource management in india's public health services : a view from the front lines |
| publisher |
World Bank, Washington, DC |
| publishDate |
2014 |
| url |
http://documents.worldbank.org/curated/en/2014/06/19737148/parallel-systems-human-resource-management-indias-public-health-services-view-front-lines http://hdl.handle.net/10986/19065 |
| _version_ |
1764443052691161088 |
| spelling |
okr-10986-190652021-04-23T14:03:50Z Parallel Systems and Human Resource Management in India's Public Health Services : A View from the Front Lines La Forgia, Gerard Raha, Shomikho Shaik, Shabbeer Maheshwari, Sunil Kumar Ali, Rabia ABILITY TO PAY ACCOUNTABILITIES ACCOUNTABILITY ACCOUNTABILITY MECHANISMS AGED ANTI-CORRUPTION ASSETS AUDITOR AUDITORS BASIC SERVICES BULLETIN CAPACITY BUILDING CITIZEN CITIZENS CIVIL SERVANT CIVIL SERVANTS CIVIL SOCIETY COLLUSION COMMUNITY HEALTH CONFIDENCE CORRUPTION COUNSELING CRIMINAL CRIMINAL LAW DECISION MAKING DELIVERY OF HEALTH CARE DELIVERY OF HEALTH SERVICES DELIVERY SYSTEM DELIVERY SYSTEMS DEMOCRACY DEVELOPING COUNTRIES DEVELOPMENT POLICY DISEASES DOCTORS ECONOMIC PERSPECTIVES ECONOMIC POLICIES ECONOMIC REVIEW EVALUATION TECHNIQUES FAMILY WELFARE FEMALE LITERACY FINANCIAL RESOURCES FOCUS GROUP DISCUSSIONS GOOD GOVERNANCE GOVERNMENT AGENCIES GOVERNMENT OFFICIALS HEALTH AFFAIRS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CENTRES HEALTH COMMITTEES HEALTH DELIVERY HEALTH DELIVERY SYSTEM HEALTH FINANCING HEALTH INFRASTRUCTURE HEALTH INSURANCE HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH OFFICIALS HEALTH OUTCOMES HEALTH PLANS HEALTH PROFESSIONALS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HOSPITAL HOSPITALS HOUSEHOLD SURVEYS HR HUMAN RESOURCE MANAGEMENT HUMAN RESOURCES HUMAN RESOURCES MANAGEMENT IMMUNIZATION INCOME INCOME DISTRIBUTION INFORMAL SECTOR INPATIENT CARE INSURANCE SCHEMES INTERMEDIARIES INTERNAL MIGRATION KICKBACKS LEADERSHIP LOCAL COMMUNITY LOW-INCOME COUNTRIES MANAGEMENT SYSTEMS MARITAL STATUS MEDICAL SCHOOL MIGRATION MINISTER MINISTRIES OF HEALTH MINISTRY OF HEALTH MINORITY MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SYSTEMS NURSE NURSES NURSING NUTRITION OUTPATIENT CARE PATIENT PATIENT CHOICE PATIENTS PATRONAGE PEDIATRICS PENSIONS PHYSICIAN PHYSICIANS PLACE OF RESIDENCE POLICY DISCUSSIONS POLICY MAKERS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLITICAL CHANGE POLITICAL CORRUPTION POLITICAL LEADER POLITICAL LEADERS POLITICAL PARTIES POLITICAL SUPPORT POLITICIAN POLITICIANS POLLUTION POOR HEALTH POPULAR SUPPORT PRIMARY CARE PRIVATE CARE PRIVATE HEALTH SERVICES PRIVATE SECTOR PRIVATE SECTORS PROBABILITY PROGRESS PSYCHOLOGY PUBLIC ADMINISTRATION PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH SERVICES PUBLIC HEALTH SYSTEM PUBLIC HEALTH WORKERS PUBLIC HOSPITALS PUBLIC OFFICIALS PUBLIC OPINION PUBLIC PROVIDERS PUBLIC SECTOR PUBLIC SERVICE PUBLIC SERVICES PUBLIC SPENDING QUALITY CARE QUALITY OF CARE QUANTITATIVE RESEARCH REFORM EFFORT RESEARCH METHODS RURAL AREAS RURAL HEALTH CARE SANCTIONS SANITATION SENSITIVE ISSUES SENSITIVE TOPICS SERVICE PROVIDERS SERVICE PROVISION SOCIAL DEVELOPMENT SOCIAL INFRASTRUCTURE SPOUSE SPOUSES STATE GOVERNMENT STATE GOVERNMENTS SURGERY THEFT TRANSPARENCY URBAN AREAS URBAN CENTERS VICTIMS WORKERS There is building evidence in India that the delivery of health services suffers from an actual shortfall in trained health professionals, but also from unsatisfactory results of existing service providers working in the public and private sectors. This study focusses on the public sector and examines de facto institutional and governance arrangements that may give rise to well-documented provider behaviors such as absenteeism, which can adversely affect service delivery processes and outcomes. The paper considers four human resource management subsystems: postings, transfers, promotions, and disciplinary practices. The four subsystems are analyzed from the perspective of front line workers, that is, physicians working in rural health care facilities operated by two state governments. Physicians were sampled in one post-reform state that has instituted human resource management reforms and one pre-reform state that has not. The findings are based on quantitative and qualitative measurement. The results show that formal rules are undermined by a parallel modus operandi in which desirable posts are often determined by political connections and side payments. The evidence suggests an institutional environment in which formal rules of accountability are trumped by a parallel set of accountabilities. These systems appear so entrenched that reforms have borne no significant effect. 2014-07-30T14:09:18Z 2014-07-30T14:09:18Z 2014-06 http://documents.worldbank.org/curated/en/2014/06/19737148/parallel-systems-human-resource-management-indias-public-health-services-view-front-lines http://hdl.handle.net/10986/19065 English en_US Policy Research Working Paper;No. 6953 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research South Asia India |